Detours on the Road to Recovery: What Factors Delay Readiness to Return to Intended Oncologic Therapy (RIOT) After Liver Resection for Malignancy?

Detours on the Road to Recovery: What Factors Delay Readiness to Return to Intended Oncologic Therapy (RIOT) After Liver Resection for Malignancy?

Lillemoe HA et al. Detours on the Road to Recovery: What Factors Delay Readiness to Return to Intended Oncologic Therapy (RIOT) After Liver Resection for Malignancy? J Gastrointest Surg. 2019 Dec;23(12):2362-2371.

What is already known:

For oncological surgery one of the main goals is to get the patient back to their intended oncological therapy as soon as possible after their surgery. With improved recovery times, ERAS has had a huge impact on allowing patients to receive their treatment far sooner than previously. Delays in getting this treatment will invariably have impacts on longer term outcomes.

What this paper adds:

This was a data trawl of a prospective database looking at patients undergoing liver resection for malignancy and looking at the determining factors between patients who underwent early vs late return to intended oncological treatment (RIOT). Univariate analysis and multivariable logistic regression were performed. It was a small study, 114 patients in total and only 32 had a delayed RIOT. Patients with a high symptom burden (measured by the MD Anderson Symptom Inventory) were most likely to have delayed RIOT. Open surgery and perhaps not unsurprisingly a post-op complication were also associated with delayed RIOT. This study can help physicians identify the patients who may need that extra bit of help in the postoperative period, and try to minimise the delay for RIOT.

Chris Jones, Guildford. @chrisnjones